The effect of ambient temperature on the activity of influenza and influenza like illness in Jiangsu Province, China

Objective: Weaimed to evaluate and quantify the association between ambient temperature and activity of influenza like illness (ILI) and influenza in Jiangsu Province, China. Method: Daily data of meteorology, influenza-like illness and detected influenza virus from 1 April 2013 to 27 March 2016 were collected. Distributed lag non-linear model (DLNM) was used to quantify the exposure-lag-response of ILI and influenza activity to daily average temperature. Result: Influenza A virus (Flu-A) circulated throughout the year with two peaks at -4 degrees C and 28 degrees C respectively, while influenza B (Flu-B) viruses were usually tested positive in winter or early spring and peaked at 5 degrees C. The lag-response curves revealed that the RR of ILI increased with time and peaked 1 day later at low temperature (3 degrees C), however, the maximum RR of ILI caused by high temperature (26 degrees C) appeared immediately on day 0, the similar phenomena of immediate effect to ILI at high temperature were also observed in the lag-response curve for Flu-A or Flu-B. Conclusion: ILI and Flu-A experienced two peaks of circulates at both low and high temperature in Jiangsu. The influenza viruses activity did drive up the rising of ILI%, particularly the activity of Flu-A which circulated throughout the year played a crucial role. Regional homogeneity was the relatively mainstream in aspects of cumulative association between influenza activity and temperature in Jiangsu Province. (C) 2018 Elsevier B.V. All rights reserved.